Recent results

[Sunflower535]

I had blood tests done with medichecks last week. They are as follows. I have been feeling reasonably well with almost no fatigue, just the odd day but getting less. I'm on 50mg of thyroxine. I did the test first thing and stuck by all the rules that are required for a proper result. I am gluten free for a wee while now.

TS H - 2.88 (0.27 -4.2)

T4 -21 (12-22)

T3 - 4.3 (3.1 - 6.8)

T4 T3 ratio is 4.884 according to the thyroid table but I don't understand if this is okay or not

thyroglobulin- 177iu/ml max 115

TPO - 466iu/ml

Less than 34

CRP - 0.433 mgl(minimum 3)

Folate 26.4 (ugl8.83 - 60.8) in taking folate supplement

Vitamin b12 nmol- 97.8 (37.5 - 188)

Vitamin d - 184 nmol(50-250) on 1000 mg vitamin d every other day

Ferritin 208 (30-650

According to medicare all okay except for antibodies.

Just wanted to know if T 3 okay. I looked at the thyroid chart but wasn't sure what the ideal percentages should be.

Any advice much appreciated.

[greygoose]

I don't know anything about ratios and I'm not interested enough to learn. As far as I'm concerned they're a red herring and don't have any meaning for hypo. But, you are a poor converter, and your FT3 looks a bit low. But, if you feel good, that's all that counts.

[Sunflower535 in reply to greygoose]

Thanks. Can I ask how do you work out that I'm poor converter. Would like to understand more fully.

[greygoose in reply to Sunflower535]

T4 -21 (12-22) 90.00%

T3 - 4.3 (3.1 - 6.8) 32.43%

Percentage-wise, your FT4 is 90% through the range, but your FT3 is only 32%. If you were a good converter, the FT3 would only be slightly lower than the FT4, say round 85%.

But, then if you were converting well, your FT4 would not be that high because more of it would be converted to T3.

That said, how long was the gap between your last dose of levo and the blood draw, because your FT4 is pretty high for someone on only 50 mcg levo?

Handy converter for working out percentages:

thyroid.dopiaza.org/

[Sunflower535 in reply to greygoose]

Last dose was 14 hours before. The previous day at 6am

[SlowDragon Administrator in reply to Sunflower535]

Last dose levothyroxine should be 24 hours before test

[Sunflower535 in reply to SlowDragon]

6am the day is 24. Sorry that was typo.but was 24

[SlowDragon Administrator in reply to Sunflower535]

How long have you been on just 50mcg

You’re currently very poor converter of Ft4 to Ft3

Which brand of levothyroxine are you taking

Suggest you ask for trial increase in levothyroxine to 50mcg and 75mcg alternate days

High thyroid antibodies confirms autoimmune thyroid disease, also called Hashimoto’s

You may need to also try dairy free diet

Did you stop any supplements that contain biotin a week before blood test - eg vitamin B complex

[Sunflower535 in reply to SlowDragon]

I take Mercurypharma. I am just getting used to the Gluten Free but will attempt to do dairy free at some point. It's a lot to learn - gluten in nearly everything. I don't take any vitamins that contain biotin - to my knowledge - I only take Folate (on it's own - no vitamin B) Magnesium, Flaxseed oil capsules for my dry eyes, and vitamin d and K2 every other day.

I don't know that asking my doctor to increase will work - the job I had to get on to 50 mg was a nightmare! I have to go to GP for bloods at end of October so I might just wait till then and see how I feel and if I am in any way tired or fatigued mention it at that stage. As I said, I feel mostly okay these days with the odd bad day, except for a bout of acid reflux. They think I am a hypochondriac as it is!

[SlowDragon Administrator in reply to Sunflower535]

Levothyroxine doesn’t “top up” your own thyroid, it replaces it. On levothyroxine TSH reduces (message from pituitary to tell thyroid to work) and your own thyroid slowly starts to shut down.

So you will need further increases in levothyroxine over coming months

Meanwhile….acid reflux and low stomach acid

Acid reflux is extremely common hypothyroid symptom due to low stomach acid (frequently misdiagnosed as high stomach acid)

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

How to test your stomach acid levels

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Useful post and recipe book

healthunlocked.com/thyroidu...

[Lulu2607]

Hi Sunflower535 . I'm not an expert but your results look fine to me and more importantly you feel good so no problems at the moment. My only advice would be to keep an eye on your health as I know from experience that being hypothyroid means we can get quickly affected by stress and emotional /physical strain and once vitamin and nutrient levels are affected it can bring your health down quite rapidly compared to non hypo people who may be more resilient.

[Sunflower535 in reply to Lulu2607]

Thank you. I have found that when stressed, I do feel worse. I'll do as you say and keep an eye on things. My reflux is the only thing I have issues with at the minute, but that's my own fault, eating what I shouldn't , but I'll get that back on track soon.

[pennyannie]

Hello Sunflower :

When on T4 monotherapy we generally feel best when our T4 is up towards / in - the top quadrant of its range as this should in theory convert to a decent level of T3 - at around a 1/4 ratio - T3//T4.

So with a T4 reading of 21.00 in theory - this would produce a T3 at around 5.25 :

The accepted conversion ratio is said to be 1 / 3.50 - 4.50 - T3/T4 with most of us feeling at our best when we come in this ratio at 4 or under :

So if I divide your T4 reading by your T3 reading I'm getting 4.88 - so slightly wide of centre.

Once on T4 monotherapy we generally feel best when the TSH is under 2 however since your T4 is already at the top of the range at 90 % it is not a question of more T4 to lower the TSH - but likely a little T3 to rebalance your T3/T4 thyroid hormones.

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal -

I now aim for a ferritin at around 100 - folate around 20 - active B12 75 ++ ( serum B12 500 ++ ) and vitamin D around 100:

Conversion of T4 into T3 can also be down regulated by any any physiological stress ( emotional or physical ) inflammation, antibodies, depression, dieting and ageing so some thins are more easily ' fixed ' than others.

[Sunflower535 in reply to pennyannie]

Pennyannie. Thanks for that - my stress levels have been high as I had a daughter leave home to go to England for university. I am normally an anxious person but that whole transition has been very difficult for me so I'm more anxious than usual. It will settle in time as I adapt to the change but it probably isn't doing me any good health wise. Thanks too for all those levels - that is really useful.

[pennyannie in reply to Sunflower535]

Ok then - hope that helps explain things a bit clearer to you.

I'm sure your daughter will be fine and probably looking forward to ' striking out ' a bit - I remember visiting my niece for a long weekend when she left home for university - is this an option you could think about for yourself ?

If you visit her - she can't actually give you a bag of laundry to do while you're there - can she !!

[Sunflower535 in reply to pennyannie]

Thanks again - I'm happy to just talk on the phone for now to her - she's fine and me visiting might unsettle her and it's such a problem to get off work - which adds more stress. The time will fly till Christmas anyway and she'll be home then for a month.

[SlowDragon Administrator in reply to Sunflower535]

Anxiety is common hypothyroid symptom.

Adrenals try to compensate for low Ft3 …..results in feeling “tired but wired” and high cortisol

Try some gentle exercise every day ….just a slow walk around the block, or meditation or yoga, or Thai Chi

Nothing too strenuous

[Polly91 in reply to SlowDragon]

So true SD!

When you’re stressed does cortisol go up? I’ve read posts on here that suggest tired adrenals usually lead to low cortisol? I’m probably being thick !!

[SlowDragon Administrator in reply to Polly91]

Initially Cortisol rises, but eventually after many months at high levels adrenals can’t keep up, then levels start to drop

It’s why an anti anxiety medication or yoga or meditation that lowers stress can improve high or low cortisol

[Sunflower535 in reply to SlowDragon]

Thank you SlowDragon. Will put all that into action.

[Polly91 in reply to SlowDragon]

Makes sense. Thanks SD

[Polly91]

sone excellent advice as always.

Sunflower just to reiterate I too have realised I always need more thyroid hormone when I’m stressed (& also when I’m cold so in the winter!) so good idea to keep an eye on it.

[Sunflower535 in reply to Polly91]

That's good to know - I will keep an eye on that too. Thanks so much. All this is so helpful.